Rate of avascular necrosis and time to surgery in proximal humerus fractures

PURPOSE

Avascular necrosis (AVN) of the humeral head is a devastating complication of proximal humeral fracture (PHF) that often results in long-term morbidity for the patient. Rates of AVN depend on the number of fracture fragments and are highly variable. The literature suggests that timely stable and anatomic reduction may decrease the rate at which AVN develops after PHF. To our knowledge, there is no literature published investigating a temporal relationship between the timing of PHF fixation and rates of AVN.

METHODS

Operative records of one orthopedic trauma surgeon were used to identify patients that underwent open reduction internal fixation for PHF at our institution between 2007 and 2012. Radiographs at presentation were reviewed and used to classify the fractures into two, three or four parts. Date and time of the initial radiograph were recorded as were the date and time of available intra-operative fluoroscopic images. The time from presentation radiograph to operative fixation was calculated (hours). Available follow-up plain films were then reviewed and evaluated for the presence or absence of humeral head AVN.

RESULTS

Time to surgery (less than or greater than 72 h) and patient age did not correlate with development of AVN after PHF (p > 0.26). Notably, the number of fracture fragments did influence the rate of AVN identified in patients with PHF (p = 0.002).

CONCLUSION

Early operative intervention does not appear to decrease the rate of development of avascular necrosis after PHF.

Metabolomic analysis of human plasma reveals that arginine is depleted in knee osteoarthritis patients

OBJECTIVE

To identify novel biomarker(s) for knee osteoarthritis (OA) using a metabolomics approach.

METHOD

We utilized a two-stage case-control study design. Plasma samples were collected from knee OA patients and healthy controls after 8-h fasting and metabolically profiled using a targeted metabolomics assay kit. Linear regression was used to identify novel metabolic markers for OA. Receiver operating characteristic (ROC) analysis was used to examine diagnostic values. Gene expression analysis was performed on human cartilage to explore the potential mechanism for the novel OA marker(s).

RESULTS

Sixty-four knee OA patients and 45 controls were included in the discovery stage and 72 knee OA patients and 76 age and sex matched controls were included in the validation stage. We identified and confirmed six metabolites that were significantly associated with knee OA, of which arginine was the most significant metabolite (P < 3.5 × 10(-13)) with knee OA patients having on average 69 μM lower than that in controls. ROC analysis showed that arginine had the greatest diagnostic value with area under the curve (AUC) of 0.984. The optimal cutoff of arginine concentration was 57 μM with 98.3% sensitivity and 89% specificity. The depletion of arginine in OA patients was most likely due to the over activity of arginine to ornithine pathway, leading to imbalance between cartilage repair and degradation.

CONCLUSION

Arginine is significantly depleted in refractory knee OA patients. Further studies within a longitudinal setting are required to examine whether arginine can predict early OA changes.

Influence of extraction technique on the anti-oxidative potential of hawthorn (Crataegus monogyna) extracts in bovine muscle homogenates

Six extracts were prepared from hawthorn (Crataegus monogyna) leaves and flowers (HLF) and berries (HB) using solid-liquid [traditional (T) (HLFT, HBT), sonicated (S) (HLFS, HBS)] and supercritical fluid (C) extraction (HLFC, HBC) techniques. The antioxidant activities of HLF and HB extracts were characterised using in vitro antioxidant assays (TPC, DPPH, FRAP) and in 25% bovine muscle (longissimus lumborum) homogenates (lipid oxidation (TBARS), oxymyoglobin (% of total myoglobin)) after 24h storage at 4°C. Hawthorn extracts exhibited varying degrees of antioxidant potency. In vitro and muscle homogenate (TBARS) antioxidant activity followed the order: HLFS>HLFT and HBT>HBS. In supercritical fluid extracts, HLFC>HBC (in vitro antioxidant activity) and HLFC≈HBC (TBARS). All extracts (except HBS) reduced oxymyoglobin oxidation. The HLFS extract had the highest antioxidant activity in all test systems. Supercritical fluid extraction (SFE) exhibited potential as a technique for the manufacture of functional ingredients (antioxidants) from hawthorn for use in muscle foods.

Investigation of the migration of triclabendazole residues to milk products manufactured from bovine milk, and stability therein, following lactating cow treatment

Triclabendazole (TCB) is a flukicide used in the treatment of liver fluke in cattle; however, its use is currently prohibited in lactating dairy cows. In this study, following administration of 10% Fasinex (triclabendazole, Novartis Animal Health UK Ltd., Camberley, UK) the milk of 6 animals was used to manufacture dairy products, to ascertain if TCB residues in milk migrate into dairy products. The detection limit of the ultra-high-performance liquid chromatography-tandem mass spectrometry method used was 0.67 μg/kg. The highest concentrations of TCB residue measured, within the individual cow milk yield, was 1,529 ± 244 µg/kg (n=6), on d 2 posttreatment. Days 2 and 23 posttreatment represented high and low residue concentrations, respectively. At each of these 2 time points, the milk was pooled into 2 independent aliquots and refrigerated. Milk products, including cheese, butter, and skim milk powder were manufactured using pasteurized and unpasteurized milk from each aliquot. The results for high residue milks demonstrated that TCB residues concentrated in the cheese by a factor of 5 (5,372 vs. 918 µg/kg for cheese vs. milk) compared with the starting milk. Residue concentrations are the sum of TCB and its metabolites, expressed as keto-TCB. Residues were concentrated in the butter by a factor of 9 (9,177 vs. 1,082 μg/kg for butter vs. milk) compared with the starting milk. For milk, which was separated to skim milk and cream fractions, the residues were concentrated in the cream. Once skim milk powder was manufactured from the skim milk fraction, the residue in powder was concentrated 15-fold compared with the starting skim milk (7,252 vs. 423 µg/kg for powder vs. skim milk), despite the high temperature (185 °C) required during powder manufacture. For products manufactured from milk with low residue concentrations at d 23 posttreatment, TCB residues were detected in butter, cheese, and skim milk powder, even though there was no detectable residue in the milk used to manufacture these products. Triclabendazole residues were concentrated in some milk products (despite manufacturing treatments), exceeding residue levels in the starting milk and, depending on the storage conditions, may be relatively stable over time.

Sick individuals and sick populations: 20 years later

Twenty years after Geoffrey Rose published his classic paper, the central messages remain highly relevant to modern public health policy and practice. The individual and population approaches are fundamentally different but both are needed. Recent examples of powerful population approaches prove Rose's point that norms can change benefiting the most deprived. Individual approaches have also succeeded but their protection of the most deprived communities is limited. Consumerism in health and over-reliance on individual approaches risk widening health inequalities.

Impacts of microcystins on the feeding behaviour and energy balance of zebra mussels, Dreissena polymorpha: a bioenergetics approach

Microcystins are produced by bloom-forming cyanobacteria and pose significant health and ecological problems. To investigate the impacts of these biotoxins on the physiology of the zebra mussels, Dreissena polymorpha, a series of short-term feeding experiments were conducted in the laboratory. We used five microalgal diets consisting of single-cell suspensions of the green algae, Chlorella vulgaris, the diatom, Asterionella formosa, the cryptophyte, Cryptomonas sp. and two strains of the toxic cyanobacterium, Microcystis aeruginosa (strains CCAP 1450/06 and CCAP 1450/10). A sixth diet was a mixture of the diatom and the CCAP 1450/10 cyanobacterial strain. The low-toxicity strain CCAP 1450/06 contained 7.4 microg l(-1) of the MC-LR variant while the very toxic strain CCAP 1450/10 contained 23.8 microg l(-1) of MC-LR and 82.9 microg l(-1) of MC-LF. A flow-through system was designed to measure the following feeding parameters: clearance, filtration, ingestion and absorption rates. Ultimately the scope for growth (SFG) was determined as a net energy balance. We observed that mussels cleared the cyanobacterial species containing MC-LF (mean+/-95% confidence interval) at a significant lower rate (498+/-82 ml h(-1) g(-1) for the single cell suspension and 663+/-100 ml h(-1) g(-1) for the mixture diet) than all of the non-toxic species and the cyanobacterium containing MC-LR (all above 1l h(-1) g(-1)). The same pattern was observed with all the feeding parameters, particularly absorption rates. Furthermore, MC-LF caused an acute irritant response manifested by the production of 'pseudodiarrhoea', unusually fluid pseudofaeces, rich in mucus and MC-LF-producing Microcystis cells, ejected through the pedal gape of the mussels. This overall response therefore demonstrates selective rejection of MC-LF-producing cyanobacteria by zebra mussels, enhancing the presence of the very toxic MC-LF-producing M. aeruginosa in mixed cyanobacterial blooms and in the benthos. Finally, we observed that the SFG (mean+/-95% confidence interval) of mussels feeding on M. aeruginosa containing MC-LF was significantly lower (34.0+/-18.8 J h(-1) g(-1) for the single cell suspension and 83.1+/-53.0 J h(-1) g(-1) for the mixture diet) than for mussels ingesting non-toxic diets, except for C. vulgaris (all above 200 J h(-1)g(-1)). This reveals a sublethal, stressful effect of microcystins (particularly MC-LF) on the feeding behaviour and energy balance of the zebra mussel.

Improved high-performance liquid chromatographic method for the determination of domoic acid and analogues in shellfish: effect of pH

Domoic acid (DA) is a naturally-occurring amino acid that causes a form of human intoxication called amnesic shellfish poisoning (ASP) following the consumption of shellfish. A rapid and sensitive HPLC-UV method has been developed for analysis of DA and analogues in shellfish without the need for SPE clean-up. Isocratic chromatographic separation of DA and its isomers from shellfish matrix interferences and from the prevalent amino acid, tryptophan, was achieved by careful control of the mobile phase pH. The optimised pH was found to be 2.5 when using a Luna(2) C18 column. Sample extraction was verified with control extracts from shellfish spiked at 5.0 and 10.0 microg/g of DA and with certified reference material. The average extraction efficiency was 98.5%. The calibration, based on mussel tissue spiked with DA standard, was linear in the range 0.05-5.0 microg/ml (r = 0.9999) and the detection limit (signal:noise 3:1) was better than 25 ng/ml. The DA assay achieved good precision; %RSD = 1.63 (intra-day, n = 6) and %RSD = 3.7 (inter-day, n = 8). This method was successfully applied to a variety of shellfish species, allowing the rapid screening of a large number of samples per day (20-30), without the need for SPE clean-up. Quantitative data were obtained for shellfish samples containing domoic acid in the concentration range 0.25-330 microg/g. Using the same chromatographic conditions, LC-MS3 was used to determine DA and its isomers, isodomoic acid D and epi-domoic acid, in scallop tissues.

Azaspiracid poisoning, the food-borne illness associated with shellfish consumption

Azaspiracid poisoning (AZP) is a recently discovered toxic syndrome that was identified following severe gastrointestinal illness from the consumption of contaminated mussels (Mytilus edulis). The implicated toxins, azaspiracids, are polyethers with unprecedented structural features. Studies toward total toxin synthesis revealed that the initial published structures were incorrect and they have now been revised. These toxins accumulate in bivalve molluscs that feed on toxic microalgae of the genus Protoperidinium, previously considered to be toxicologically benign. Although first identified in shellfish from Ireland, azaspiracid contamination of several types of bivalve shellfish species has now been confirmed throughout the western coastline of Europe. Toxicological studies have indicated that azaspiracids can induce widespread organ damage in mice and that they are probably more dangerous than previously known classes of shellfish toxins. The exclusive reliance on live animal bioassays to monitor azaspiracids in shellfish failed to prevent human intoxications. This was a consequence of poor sensitivity of the assay and the fact that azaspiracids are not exclusively found in the shellfish digestive glands used for toxin testing. The strict regulatory control of azaspiracids in shellfish now requires frequent testing of shellfish using highly specific and sensitive methods involving liquid chromatography-mass spectrometry.

Food safety implications of the distribution of azaspiracids in the tissue compartments of scallops (Pecten maximus)

Azaspiracids, a new class of shellfish toxins, have been implicated in several recent incidents of human intoxications following the consumption of mussels (Mytilus edulis). A study was undertaken to examine the distribution of azaspiracid poisoning (AZP) toxins in scallops (Pecten maximus) and individual shellfish were dissected into five tissue fractions for the determination of toxin composition. Separation of the predominant azaspiracids, AZA1-3, was achieved using reversed-phase liquid chromatography with detection by positive electrospray multiple tandem mass spectrometry. The AZP toxin composition was determined in the adductor muscle (meat), gonad (roe), hepatopancreas (digestive glands), mantle and gill of scallops. Substantial differences in the AZP toxin levels between tissue compartments were observed and toxins were concentrated predominantly, about 85%, in the hepatopancreas. There was also a significant variation in the total toxin levels between individual scallops from the same sample batch and the RSD was 60% (n = 9). Interestingly, although all three AZP toxins were present in phytoplankton and mussels, AZA3 was not detected in the scallop samples examined. It was concluded that to improve food safety, only the adductor muscle and gonad of scallops should be permitted for sale to the public.

Liquid chromatography with electrospray ion-trap mass spectrometry for the determination of yessotoxins in shellfish

Yessotoxins are a group of large polyether toxins, produced by marine dinoflagellates, which cause widespread contamination of filter-feeding shellfish. A new, sensitive liquid chromatography-mass spectrometry (LC-MS) method has been developed for the determination of yessotoxin (YTX) and 45-hydroxy-yessotoxin (45-OHYTX), a major metabolite in shellfish. The LC system was coupled, via an electrospray ionisation (ESI) source, to an ion-trap MS in negative mode. The molecular related ion species at m/z 1141 [M-2Na+H]- was used as the parent ion for multiple MS experiments. MS-MS and MS3 gave major fragment ions at m/z 1061 [1141-SO3H]- and m/z 945 [1061-C9H12O]-. Predominant ions, that are due to the fragmentation of the backbone structure of YTXs, were observed at the MS4 stage. Reversed-phase LC using a C16 amide column was preferable to C18 phases for the separation of YTX and 45-OHYTX. Optimum calibration and reproducibility data were obtained for YTX using LC-MS-MS; r 2=0.9960, RSD < or = 6.3% at 0.25 microg YTX/g (n=5). The detection limit (S/N=3) was 30 pg YTX on-column which corresponded to 3 ng/g shellfish tissue.

DSP toxin profile in the coastal waters of the central Adriatic Sea

A monitoring program, carried out in 1996 and 1997, has confirmed that toxic compounds, other than the most frequently detected toxins okadaic acid (OA) and dinophysistoxin-1 (DTX-1), are involved in DSP phenomena in the Adriatic Sea. Toxicity was assessed by the mouse bioassay; the content and the nature of the toxic components were established through fluorometric HPLC analysis combined with mass spectrometry. A rare pectenotoxin-2 (PTX-2) derivative, 7-epi-pectenotoxin-2 seco acid (7-epi-PTX-2SA), was the exclusive contaminant of samples collected from the central Adriatic in 1996. Contrary to its marked oral toxicity, intraperitoneally 7-epi-PTX-2SA displayed no toxic effects, hampering its detection by the mouse bioassay. In 1997, its concentration and frequency of appearance were lower than in 1996, with concomitant occurrence of OA, DTX-2, and a new unidentified component related to the DSP toxic group of compounds. This is the first report on the occurrence of DTX-2 in Adriatic mussels. A survey of the phytoplankton community in the surrounding seawater has established the presence of Prorocentrum micans and several potentially toxic species from the Dinophysis genus. A case of unexplained toxicity, associated with the occurrence of Gonyaulax polyedra, suggested possible shellfish contamination with yessotoxin (YTX).

Bioaccumulation and detoxication of nodularin in tissues of flounder (Platichthys flesus), mussels (Mytilus edulis, Dreissena polymorpha), and clams (Macoma balthica) from the northern Baltic Sea

Cyanobacterial hepatotoxin accumulation in mussels (Mytilus edulis, Dreissena polymorpha), clam (Macoma balthica), and flounder (Platichthys flesus) tissues was measured. Flounder were caught with gillnets from the western Gulf of Finland on 21 August 1999, 25 July 2000, and 25 August 2000. Blue mussels were collected from: (1) a steel cage at a depth of 3 m on 20 August 1999, (2) an enclosure at depths of 3-5 m, and (3) an artificial reef (wreck at 25-30 m) in the western Gulf of Finland between June and September 2000. Furthermore, blue mussels were collected from two sites between August and October 2000: south of the town of Hanko at depths of 5 and 20 m in the western Gulf of Finland and south of the city of Helsinki at a depth of 7 m in the central Gulf of Finland. M. balthica and D. polymorpha were collected at a depth of 12 m from Russian waters in the eastern Gulf of Finland on 1-4 August 2000. The samples were analyzed for the cyanobacterial hepatotoxins nodularin (NODLN) and microcystins (MCs) using enzyme-linked immunosorbent assay (ELISA), liquid chromatography-mass spectrometry (LC-MS), and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). ELISA indicated a time-dependent accumulation of hepatotoxins in flounder liver up to 400 +/- 10 (SD) microg/kg on 25 August 2000. No hepatotoxins were detected in flounder muscle samples. In blue mussels, collected from an enclosure 3-5 m deep in the western Gulf of Finland on 23 August 2000, ELISA indicated cyanobacterial hepatotoxins up to 1490 +/- 60 microg/kg dry wt. Blue mussels collected from the other sites contained less cyanobacterial hepatotoxins (40-130 microg/kg dry wt). Clams and mussels from Russian waters contained cyanobacterial hepatotoxin at about 100-130 microg/kg dry wt. Total hepatotoxin levels in mussels from enclosures decreased from August to September, indicating at least partial detoxication/depuration of the toxins. LC-MS verified the presence of NODLN in mussels and flounder. Typical detoxication conjugates were observed by MALDI-TOF-MS in mussel samples collected during August 2000. In deeper-living wreck mussels cyanobacterial hepatotoxin levels continued to increase, from August to September, indicating that portions of cyanobacterial hepatotoxins reach the sea floor. NODLN bioaccumulation is a constant phenomenon in the area.

Azaspiracid shellfish poisoning: unusual toxin dynamics in shellfish and the increased risk of acute human intoxications

A number of recent acute human intoxications in Europe from the consumption of Irish mussels have been attributed to the presence of a new class of toxins named azaspiracids. The study demonstrates that azaspiracids behave differently from other polyether toxins, and this accounts for most false-negative results in the mouse bioassay employed by regulatory agencies to detect azaspiracids. Typically, polyether toxins are concentrated in the digestive glands of shellfish, but this is not always the situation with azaspiracids. Liquid chromatography-mass spectrometry (LC-MS), especially multiple tandem MS methods, have been applied to demonstrate that azaspiracid (AZA1) and its methyl- and demethyl- analogues, AZA2 and AZA3 respectively, are distributed throughout shellfish tissues. Using conventional mouse bioassay protocols, only 0-40% of the total azaspiracid content of shellfish was used in the assay, which could directly account for false-negative results. It was also observed that the toxin profiles differed significantly in various mussel tissues with AZA1 as the predominant toxin in the digestive glands and AZA3 predominant in the remaining tissues.

Liquid chromatography with electrospray ion trap mass spectrometry for the determination of five azaspiracids in shellfish

Azaspiracid poisoning (AZP) is a new human toxic syndrome that is caused by the consumption of shellfish that have been feeding on harmful marine microalgae. A liquid chromatography-mass spectrometry (LC-MS) method has been developed for the determination of the three most prevalent toxins, azaspiracid (AZA1), 8-methylazaspiracid (AZA2) and 22-demethylazaspiracid (AZA3) as well as the isomeric hydroxylated analogues, AZA4 and AZA5. Separation of five azaspiracids was achieved on a C18 column (Luna-2, 150 x 2 mm, 5 microm) with isocratic elution using acetonitrile-water containing trifluoroacetic acid and ammonium acetate as eluent modifiers. Using an electrospray ionisation (ESI) source with an ion-trap mass spectrometer, the spectra showed the protonated molecules, [M+H]+, with most major product ions due to the sequential loss of two water molecules. A characteristic fragmentation pathway that was observed in each azaspiracid was due to the cleavage of the A-ring at C9-C10 for each toxin. It was possible to select unique ion combinations to distinguish between the isomeric azaspiracids, AZA4 and AZA5. Highly sensitive LC-MS3 analytical methods were compared and the detection limits were 5-40 pg on-column. Linear calibrations were obtained for AZA1 in shellfish in the range 0.05-1.00 microg/ml (r2 = 0.9974) and good reproducibility was observed with a relative standard deviation (%RSD) of 1.8 for 0.9 microg AZAI/ml (n=5). The %RSD values for the minor toxins, AZA4 and AZA5, using LC-MS3 (A-ring fragmentation) were 12.3 and 8.1 (0.02 microg/ml; n=7), respectively. The selectivity of toxin determination was enhanced using LC-MS-MS with high energy WideBand activation.

Determination of domoic acid in shellfish by liquid chromatography with electrospray ionization and multiple tandem mass spectrometry

Amnesic shellfish poisoning is a potentially lethal human toxic syndrome which is caused by domoic acid (DA) that originates in marine phytoplankton belonging to the Pseudonitzschia genus. A new sensitive liquid chromatographic-mass spectrometry (LC-MS) method has been developed for the determination of DA in various marine biological samples. The characteristic fragmentation pathways for DA were established using multiple stage MS on selected daughter ions, which were sequentially trapped and fragmented. Chromatography was performed using a gradient of acetonitrile-water (5:95 to 40:60), containing trifluoroacetic acid (0.05%), over 25 min at 0.2 ml/min with a C18 column (Luna-2, 150 x 2.0 mm, 5 microm). Using electrospray ionisation, multiple tandem MS experiments were performed with an ion-trap mass spectrometer (Finnigan MAT LCQ). The protonated DA molecule was the precursor ion, m/z 312, and the relative collision energies were optimised for multiple MS (MS(n), n = 2-4) studies. LC-MS3 using the ions, m/z 266 and 220, from the loss of two HCOOH molecules, produced the best sensitivity data. Calibration data for various MS modes were: MS (0.05-10 microg DA/ml, r2 = 0.9973); MS2 (0.025-10 microg DA/ml, r2=0.9997); MS3 (0.025-10 microg DA/ml, 0.9994). The detection limits (3:1 signal:noise) were better than 0.02 microg DA/ml for LC-MS, 0.014 microg DA/ml for LC-MS2 and 0.008 microg DA/ml for LC-MS3. This method was applied to determine DA in scallop (Pecten maximus) tissues, which subsequently led to the closure of several shellfish harvesting sites on the west coast of Ireland.

Improving influenza immunisation coverage in 2000-2001: a baseline survey, review of the evidence and sharing of best practice

In May 2000 a new government target of 70% uptake in people aged 65 and over was introduced for influenza immunisation, with a minimum of 60% uptake in 2000-2001. A postal survey of influenza immunisation coverage in over 75 year olds during 1999-2000 was undertaken in our district's general practices. The evidence on interventions which improve coverage was compared to local practice. General Practitioners and their Primary Care Groups/Trust received feedback on their performance, and best practice was shared. The findings were used to inform the immunisation campaign for 2000-01. The survey response rate was 74%. The district coverage was 50%, ranging from 7% to 97% between practices. Practices achieving high coverage rates combined good patient identification with personalised patient invitation and well-organised clinics. The work that went on in the district achieved an overall influenza immunisation coverage of 62% in 2000-01.

The occurrence of 7-epi-pectenotoxin-2 seco acid in the coastal waters of the central Adriatic (Kastela Bay)

Okadaic acid (OA) and 7-epi-pectenotoxin-2 seco acid (7-epi-PTX-2SA) were identified as the toxic determinants in mussels from the central Adriatic Sea. The nature of the pectenotoxin-2 derivative was confirmed by chromatographic comparison with toxins present in algae extracts of Dinophysis acuta from Ireland, and by mass spectrometric analysis. The origin of shellfish toxicity has been associated with the occurrence of the Dinophysis species. This is the first report on the incidence of 7-epi-PTX-2SA in the Adriatic region.

Development of a method for the identification of azaspiracid in shellfish by liquid chromatography-tandem mass spectrometry

Azaspiracid is the main toxin responsible for a number of recent human intoxications in Europe resulting from shellfish consumption. The first micro liquid chromatography-tandem mass spectrometry (micro-LC-MS-MS) method was developed for the determination of this novel shellfish poisoning toxin in mussels. The analyte was extracted from whole mussel meat with acetone and chromatographed on a C18 reversed-phase column (1.0 mm I.D.) by isocratic elution at 30 microl/min with acetonitrile-water (85:15, v/v), containing 0.03% trifluoroacetic acid. The toxin was ionised in an ionspray interface operating in the positive ion mode, where only the intact protonated molecule, [M+H]+, was generated at m/z 842. This served as precursor ion for collision-induced dissociation and three product ions, [M+H-nH2O]- with n=1-3, were identified for the unambiguous toxin confirmation by selected reaction monitoring LC-MS-MS analysis. A detection limit of 20 pg, based on a 3:1 signal-to-noise ratio, was achieved for the analyte. This LC-MS-MS method was successfully applied to determine azaspiracid in toxic cultivated shellfish from two regions of Ireland.

Sensitive determination of anatoxin-a, homoanatoxin-a and their degradation products by liquid chromatography with fluorimetric detection

Cyanobacterial neurotoxins have been implicated in animal deaths resulting from drinking contaminated water. Anatoxin-a (AN) and homoanatoxin-a (HMAN) have previously been analysed using high-performance liquid chromatography (HPLC) with UV detection, but this procedure is insufficiently sensitive and is subject to interferences. A sensitive fluorimetric (FL) method for determining AN was recently developed using derivatisation with 4-fluoro-7-nitro-2,1,3-benzoxadiazole (NBD-F) and this has been applied to the simultaneous determination of AN, HMAN and their epoxy and dihydro degradation products. Microscale syntheses were used to prepare the dihydro and epoxy derivatives from AN and HMAN. These compounds were produced in high yields, as confirmed by electrospray MS and HPLC-FL of their benzoxadiazole derivatives. All six NBD derivatives were readily separated using isocratic reversed-phase HPLC. The recoveries of these compounds from spiked water samples, using weak cation-exchange (WCX) solid-phase extraction (SPE), were 83.2-84.9% at concentrations of 10 micrograms/l. The R.S.D. values were 1.7-3.9% (n = 8) and the limits of detection were better than 10 ng/l for all six compounds, illustrating the high sensitivity of the method. This methodology was successfully applied to the analysis toxin degradation products in natural samples. Dihydroanatoxin-a (0.8 mg/g) was isolated from a benthic Oscillatoria bloom from Caragh Lake, Ireland, and was found to contain two isomers but their ratio was different from that found in the synthetic material.

Determination of diarrheic shellfish toxins in mussels by microliquid chromatography-tandem mass spectrometry

A fast, sensitive, and specific procedure for determining toxins that cause diarrheic shellfish poisoning (DSP) using microliquid chromatography coupled with tandem mass spectrometry (micro-LC-MS-MS) is reported. The lipophylic polyether acidic toxins okadaic acid (OA), its isomer dinophysistoxin-2 (DTX-2), the 35-methylokadaic acid dinophysistoxin-1 (DTX-1), and the novel toxin dinophysistoxin-1B (DTX-2B; recently isolated from Irish mussels) were extracted from shellfish tissues with acetone and chromatographed by isocratic elution at 10 microL/min with CH3 CN-H2O, 80 + 20 (v/v), containing 0.1% trifluoroacetic acid, through a C18 reversed-phase column (1.0 mm id). The chromatograph is coupled via an ion spray interface to an atmospheric pressure ionization source. Collision-induced-dissociation (CID) ion mass spectra of the protonated molecule, [M + H]+, at m/z 805 for OA, DTX-2, and DTX-2B and at m/z 819 for DTX-1, were obtained in MS-MS experiments to identify 2 diagnostic fragment ions for each analyte that could be used for selected-reaction-monitoring (SRM) micro-LC-MS-MS analysis. The CID spectrum of DTX-2B confirmed it to be a new OA isomer, like DTX-2. Standard curves obtained by SRM micro-LC-MS-MS were linear (r2 > or = 0.9992) over the range 0.05-1.00 micrograms/mL (i.e., 0.10-2.00 micrograms toxin/g hepatopancreas), and a detection limit of 15 pg/injection was obtained for each DSP toxin. Average recoveries ranged from 95 to 101%, and coefficients of variation ranged from 1.8 to 3.4%. This novel SRM micro-LC-MS-MS method was used to confirm acidic DSP toxins in Irish and Italian toxic mussels. It offers a high degree of specificity because analyte confirmation is based on retention time, molecular weight, structural information obtained from the presence of 2 diagnostic fragments for each analyte, and ion ratios. OA was found in both Irish (< or = 0.7 micrograms/g hepatopancreas) and Italian (< or = 1.5 micrograms/g hepatopancreas) mussels. DTX-1 was found only in Italian mussels (< or = 0.3 micrograms/g hepatopancreas). DTX-2 (< or = 6.1 micrograms/g hepatopancreas) and DTX-2B (< or = 0.08 micrograms/hepatopancreas) were unique to Irish shellfish.